Pankreas kanserli hastalarda sağkalıma etki eden prognostik faktörler: tek merkez deneyimi

Year 2023, , 58 - 62, 10.02.2023

Hilal Alkış

https://doi.org/10.47582/jompac.1200674

Abstract

Amaç: Çalışmanın amacı radyoterapi (RT) alan pankreas kanserli hastalarda sağkalım sonuçları ile prognoza etki eden faktörleri araştırmaktır.
Gereç ve Yöntem: Toplamda 73 pankreas kanseri olan ve 2013-2021 yılları arasında RT almış olan hastalar çalışmaya dahil edildi. Hastaların klinik, demografik ve histopatolojik özellikleri ile RT amacı (adjuvan, definitif, neoadjuvan veya palyatif) kaydedildi.
Bulgular: Hastaların medyan yaşı 62 (37-78) idi. Erkek/kadın oranı 1.6 idi. Medyan genel sağkalım adjuvan RT alanlarda (n=52) 25.7 ay (11.6-39.7 ay), definitif RT alanlarda (n=13) 16 ay (7-67 ay) ve palyatif RT alanlarda (n=7) 9 ay (5-52 ay) idi. Neoadjuvan RT alan 1 hastada medya sağkalım süresi 26.6 aydı. Lenf nodu oranı (LNO) ile genel sağkalım arasında anlamlı bir ilişki bulundu. LNO >0.4 olan hastalarn genel sağkalımı LNO ≤0.4 olanlara göre daha kötüydü (p=0.003). Dahası adjuvan RT alan ve LNO ≤0.4 hastalarda çalışmadaki geri kalan hastalara kıyasla daha iyi genel sağkalım tespit edildi. (12.1 aya karşın 7.7 ay, p=0.001). Tümör büyüklüğü tek değişkenli analizde kötü sağkalım ile ilişkili bulundu (p=0.04), ancak, çok değişkenli analizde sağkalımın sadece LNO tarafınca anlamlı oranda bulundu (p=0.01). Diğer faktörlerle sağkalım arasında anlamlı bir ilişki bulunamadı.
Sonuç: Radyoterapi alan hastalarda LNO ile genel sağkalım arasında güçlü bir ilişki vardı. Ayrıca küçük LNO olan ve adjuvan RT alan hastalarda sağkalım daha iyiydi.

Keywords

Pankreas kanseri, prognostik faktörler, sağkalım, radyoterapi

Prognostic factors for survival in pancreatic cancer patients received radiotherapy: a single-center experience

Abstract

Aim: To investigate survival outcomes and factors affecting the prognosis of patients with pancreatic cancer (PC) who received radiotherapy (RT).
Material and Method: A total of 73 patients with PC who received RT between 2013 and 2021 were included in the study. Clinical, demographic, and histopathological features of the patients, and the goal of RT (adjuvant, definitive, neoadjuvant, or palliative) were recorded.
Results: Median age of the patients was 62 (37-78). Male to female ratio was 1.6. In patients treated with adjuvant (n=52), definitive (n=13), and palliative (n=7) RT, median overall survival (OS) was 25.7 (11.6-39.7), 16 (7-67), and 9 (5-52) months, respectively. Survival time of 1 patient who received neoadjuvant RT was 26.6 months. Lymph node ratio (LNR) was significantly associated with OS. Patients with LNR ≤0.4 had better survival compared to those with LNR >0.4 (p=0.003). Furthermore, patients with LNR ≤0.4 and received adjuvant RT survived longer than the rest of the patients (12.1 vs. 7.7 months, p=0.001). Larger tumors (p=0.04) and LNR (p=0.003) were associated with poorer survival in univariate analysis, however, in the multivariate analysis, OS was found significantly affected only by LNR (p=0.01). Other factors were not found associated with survival.
Conclusion: LNR had a strong correlation with OS in PC patients treated with radiation. Smaller LNR was associated with better survival in patients who received RT in the adjuvant setting.

Keywords

pancreatic cancer, prognostic factors, survival, radiotherapy

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